NURS646 Thyroid Exam Questions
And Correct Answers
Why is the thyroid gland important? - Answer *Synthesizes thyroid hormones T4 and T3
*Regulates metabolic rate
*Essential to the function of most organ systems
*Essential for normal physiologic growth/development
*Critical for the brain development of infants and young children (Too low➤MR) Urgent
referral!
*Dietary iodine-critical precursor for T4, T3
What is the primary function of the thyroid gland? - Answer synthesis of
Thyroxine (T4) and triiodothyronine (T3).
What does the pituitary Thyrotropin do? - Answer regulates thyroid hormone production
What does TRH (thyroid releasing hormone) stimulate? - Answer TSH (thyroid
stimulating hormone) synthesis and secretion
How does Serum T4 concentration modulate the secretion of TRH and TSH? - Answer by
a negative feedback loop
What is T4 predominantly bound to? - Answer TBG (T4 binding globulin)
What does TSH stimulate? - Answer the liberation of T4 and T3 from TBG.
Which thyroid hormone is unbound and bioactive? - Answer T4
TSH from the anterior pituitary is stimulated by_______? - Answer low T4 ( neg feedback)
under the influence of TRH, somatostatin and dopamine
What occurs when Thyrotropin binds to TSH receptors on the thyroid gland? - Answer
Signals the production of T4 and some T3. As T4 rises, it signals the hypothalmus and
anterior pituitary to decrease T4 or thyroxine production
What is the most common endocrinpathy? How prevalent is it? - Answer
Hypothyroidism. Affects 2% women, 0.2%men, 0.15% children with 2.8:1 female to male
What is the most commonly acquired hypothyroidism? - Answer autoimmune
hypothyroidism or Hashimoto's thyroiditis
Why is prompt treatment of congenital hypothyroidism critical in newborns as well as
timely dosage of thyroid replacement? - Answer It is crucial for brain development.
, Hypothyroid infants at risk for permanent neuro impairment
What is the cause of hypothyroidism? - Answer *Caused by defects in any level of
hypothalamic-pit axis-(can be primary level within the gland, central from the
hypothalmus or resistance/consumptive -rare and external)
What does hypothyroidism affect? - Answer the gland itself
How do you distinguish Hashimoto's from other forms of hypothyroidism? - Answer The
presence of thyroid antibodies: high TSH and low Free T4 and T4. Check thyroid
antibodies: + antiperoxidase or antithyroglobulin ab, then that will be diagnostic. Also
rule out any other autoimmune endocrinopathies - could indicate endocrine poly
glandular syndrome
Sublingual thyroid - Answer Thyroid is not in the neck, is at the base of the tongue
How and how often does central hypothyroidism occur? - Answer 1/3000-4000 births
Abnormality of pituitary Gland. Due to thyroid dysgeneisis: abnormal anatomic
development of agenesis, hypoplasia or ectopy (not where it should be)
How do we discover congenital hypothyroidism? - Answer Screen all NB - clinically
silent and will lead to profound Neuro defects. Must f/u with NB screening.
What is central hypothyroidism? - Answer Central abnormality in pituitary gland:
decrease in TRH or TSH = decrease T4, T3. TSH is more common.
What test are conducted if central hypothyroidism is suspected? - Answer brain MRI and
pituitary to r/o adenoma or ectopic pituitary or tumor. Check other pituitary hormone
deficiencies.
What conditions must we rule out before confirming central hypothyroidism? - Answer
Need MRI of brain/pituitary to r/o pituitary adenomas, craniopharyngioma
Hypothyroidism can occur with what other pituitary hormonal deficiencies? - Answer
def-check hypoglycemia, microphallus, polyuria, midline defects. Hypoglycemia =
growth hormone deficiency. Micrfalic, polyuria or midline defect = other defects in the
pituitary hormone such as ADH or LH or FSH that help with normal sexual development
of child
What must the PCP assess prior to starting thyroid replacement? - Answer Adrenal
insufficiency = 8am corticol and ACTH
If adrenal insufficiency is confirmed with a hypothyroidism Dx, which meds are given
first? - Answer glucocorticoid replacement should begin first, in order to prevent
adrenal crisis, resulting from increased demands of enhanced metabolism from thyroid
replacement.
Sx of Hypothyroidism - Answer *Goiter
And Correct Answers
Why is the thyroid gland important? - Answer *Synthesizes thyroid hormones T4 and T3
*Regulates metabolic rate
*Essential to the function of most organ systems
*Essential for normal physiologic growth/development
*Critical for the brain development of infants and young children (Too low➤MR) Urgent
referral!
*Dietary iodine-critical precursor for T4, T3
What is the primary function of the thyroid gland? - Answer synthesis of
Thyroxine (T4) and triiodothyronine (T3).
What does the pituitary Thyrotropin do? - Answer regulates thyroid hormone production
What does TRH (thyroid releasing hormone) stimulate? - Answer TSH (thyroid
stimulating hormone) synthesis and secretion
How does Serum T4 concentration modulate the secretion of TRH and TSH? - Answer by
a negative feedback loop
What is T4 predominantly bound to? - Answer TBG (T4 binding globulin)
What does TSH stimulate? - Answer the liberation of T4 and T3 from TBG.
Which thyroid hormone is unbound and bioactive? - Answer T4
TSH from the anterior pituitary is stimulated by_______? - Answer low T4 ( neg feedback)
under the influence of TRH, somatostatin and dopamine
What occurs when Thyrotropin binds to TSH receptors on the thyroid gland? - Answer
Signals the production of T4 and some T3. As T4 rises, it signals the hypothalmus and
anterior pituitary to decrease T4 or thyroxine production
What is the most common endocrinpathy? How prevalent is it? - Answer
Hypothyroidism. Affects 2% women, 0.2%men, 0.15% children with 2.8:1 female to male
What is the most commonly acquired hypothyroidism? - Answer autoimmune
hypothyroidism or Hashimoto's thyroiditis
Why is prompt treatment of congenital hypothyroidism critical in newborns as well as
timely dosage of thyroid replacement? - Answer It is crucial for brain development.
, Hypothyroid infants at risk for permanent neuro impairment
What is the cause of hypothyroidism? - Answer *Caused by defects in any level of
hypothalamic-pit axis-(can be primary level within the gland, central from the
hypothalmus or resistance/consumptive -rare and external)
What does hypothyroidism affect? - Answer the gland itself
How do you distinguish Hashimoto's from other forms of hypothyroidism? - Answer The
presence of thyroid antibodies: high TSH and low Free T4 and T4. Check thyroid
antibodies: + antiperoxidase or antithyroglobulin ab, then that will be diagnostic. Also
rule out any other autoimmune endocrinopathies - could indicate endocrine poly
glandular syndrome
Sublingual thyroid - Answer Thyroid is not in the neck, is at the base of the tongue
How and how often does central hypothyroidism occur? - Answer 1/3000-4000 births
Abnormality of pituitary Gland. Due to thyroid dysgeneisis: abnormal anatomic
development of agenesis, hypoplasia or ectopy (not where it should be)
How do we discover congenital hypothyroidism? - Answer Screen all NB - clinically
silent and will lead to profound Neuro defects. Must f/u with NB screening.
What is central hypothyroidism? - Answer Central abnormality in pituitary gland:
decrease in TRH or TSH = decrease T4, T3. TSH is more common.
What test are conducted if central hypothyroidism is suspected? - Answer brain MRI and
pituitary to r/o adenoma or ectopic pituitary or tumor. Check other pituitary hormone
deficiencies.
What conditions must we rule out before confirming central hypothyroidism? - Answer
Need MRI of brain/pituitary to r/o pituitary adenomas, craniopharyngioma
Hypothyroidism can occur with what other pituitary hormonal deficiencies? - Answer
def-check hypoglycemia, microphallus, polyuria, midline defects. Hypoglycemia =
growth hormone deficiency. Micrfalic, polyuria or midline defect = other defects in the
pituitary hormone such as ADH or LH or FSH that help with normal sexual development
of child
What must the PCP assess prior to starting thyroid replacement? - Answer Adrenal
insufficiency = 8am corticol and ACTH
If adrenal insufficiency is confirmed with a hypothyroidism Dx, which meds are given
first? - Answer glucocorticoid replacement should begin first, in order to prevent
adrenal crisis, resulting from increased demands of enhanced metabolism from thyroid
replacement.
Sx of Hypothyroidism - Answer *Goiter
